Blood test, liver function panel
Facility: Nmc Health
Billing Code: 80076 (CPT)
- CPT Billing Code: 80076
- Insurance Median: $66
- Cash Discount Price: $71
- vs. Medicare Baseline: 8.08x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. Medicare
Understanding this gauge: We use the federal Medicare rate of $8.17 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 808% of the Medicare baseline (a markup of 708%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
Out-of-Pocket Cost Estimator
Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Aetna | $26 - $84 | 318% |
| Blue Cross Blue Shield | $32 | 392% |
| Wppa | $56 | 685% |
| Occunet | $61 | 747% |
| Medincrease Health Plan | $66 | 808% |
| Samaritan Ministries International | $66 | 808% |
| Prime Health Services | $77 | 942% |
| UnitedHealthcare | $92 | 1126% |
| Cigna | $97 | 1187% |
Consumer Guidance & Cost Commentary
For the blood test, liver function panel (CPT 80076) at Nmc Health in Newton, KS, the cash median price is $71.00, which is lower than the facility's negotiated rates for most major payers. While the facility's cash price is notably lower than the gross chargemaster of $102.00, patients with high-deductible plans may find paying out-of-pocket cheaper if their insurance negotiated rates exceed this amount. The facility offers a prompt-pay discount for upfront payments, which can further reduce the final cost, and patients should explicitly request self-pay classification before scheduling to ensure they receive the best possible rate.
When evaluating this price, it is important to compare it against the Medicare benchmark of $8.17, which serves as the objective baseline for fair pricing rather than the inflated gross charges. Although the data does not provide specific state or county average figures for this procedure, the facility's cash rate of $71.00 is significantly higher than the Medicare amount, reflecting the typical markup found in commercial billing. To avoid unexpected costs, patients should verify their deductible status before using insurance, as paying the negotiated rate may result in higher out-of-pocket expenses if the deductible has not yet been met.